LCD Reference Article Article

Rural Air Ambulance Service Protocols

A52917

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Source Article ID
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Article ID
A52917
Original ICD-9 Article ID
Not Applicable
Article Title
Rural Air Ambulance Service Protocols
Article Type
Article
Original Effective Date
10/01/2015
Revision Effective Date
10/01/2015
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Article Text
Note: This is a reprint of an article published in " Medicare A News," Issue 2064 dated November 1, 2007. This article is being reprinted to update mailing and submission information for facilities/providers that provide rural air ambulance service; this is not a new regulation.

The Center for Medicare and Medicaid Services (CMS) has issued instructions for contractors to post instructions for submission of the state or regional protocol that has been recognized or approved by the Secretary of the Department of Health and Human Services. This instruction has been published in the IOM Publication 100-08 Program Integrity Manual Chapter 6; section 6.4.

IOM Publication 100-08 Program Integrity Manual states: "Per Section 415 of the Medicare Modernization act of 2003, the reasonable and necessary requirement for rural air transport may be "deemed" to be met when the service is provided pursuant to an established State or regional emergency medical services (EMS) agency protocol. CMS defines "established" to mean those protocols, which have been reviewed and approved by State EMS agencies or have been developed according to State EMS umbrella guidelines. Additionally, the protocol must be recognized or approved by the Secretary."

Rural air ambulance providers who are anticipating transports based upon the contents of such a protocol (either State or regional) must submit that protocol in advance to the fiscal intermediaries for review and approval. Providers will also need to submit documentation that their protocol is or is based on a protocol that has been approved or recognized by the Secretary of Health and Human Services. This information should be sent to the following address for your state if Noridian is your fiscal intermediary or A/B Medicare Administrative Contractor.

Arizona
Noridian Healthcare Solutions
PO Box 6730
Fargo ND 58108-6730

Alaska
Noridian Healthcare Solutions
PO Box 6726
Fargo ND 58108-6726

Montana
Noridian Healthcare Solutions
PO Box 6732
Fargo ND 58108-6732

Washington
Noridian Healthcare Solutions
PO Box 6720
Fargo ND 58108-6720

North Dakota
Noridian Healthcare Solutions
PO Box 6709
Fargo ND 58108-6709

Oregon
Noridian Healthcare Solutions
PO Box 6726
Fargo ND 58108-6726

South Dakota
Noridian Healthcare Solutions
PO Box 6733
Fargo ND 58108-6733

Idaho
Noridian Healthcare Solutions
PO Box 6726
Fargo ND 58108-6726

Utah
Noridian Healthcare Solutions
PO Box 6724
Fargo ND 58108-6724

Minnesota
Noridian Healthcare Solutions
PO Box 6714
Fargo ND 58108-6714

Wyoming
Noridian Healthcare Solutions
PO Box 6734
Fargo ND 58108-6734

Providers may also submit the information by email if more convenient.
Email address: fiambprotocol@noridian.com.

Noridian will review the protocol and or any subsequent revisions and notify the rural air ambulance provider, via letter, of the determination within 30 days of receipt of the protocol. Approval of a protocol does not exempt the provider from the remaining Medicare requirements for rural air ambulance services. Regardless of protocol instructions regarding transport locations Medicare payment can be made only to the closet facility capable of providing the care needed by the beneficiary.

Sources: Internet Only Manual (IOM) Publication 100-08, Medicare Program Integrity Manual, Chapter 6

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Revision History Information

Revision History Date Revision History Number Revision History Explanation
10/01/2015 R1

Updated to indicate this article is not an LCD Reference Article

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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
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11/22/2023 10/01/2015 - N/A Currently in Effect You are here
03/31/2014 10/01/2015 - N/A Superseded View

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